Coronary Thrombosis Causes, Symptoms & Treatment
Contents
- Coronary Thrombosis Causes
- Symptoms Related To Coronary Thrombosis
- How Does Coronary Thrombosis Develop?
- Risk Factors For Coronary Thrombosis
- Age
- Sex
- Family History
- Hypertension / high blood pressure
- Diabetes mellitus
- Obesity/ overweight
- Smoking
- High Blood Cholesterol
- How Coronary Thrombosis Can Be Treated?
- 1- Lifestyle Changes
- 2- Medication
- 3- Surgery
- Sources
Coronary thrombosis is the formation of a blood clot inside a coronary artery, one of the blood vessels that supply the heart muscle. The clot restricts blood flow to the heart, which can cause ischemia (lack of oxygen), chest pain and dangerous heart rhythms.
Coronary thrombosis is part of ischemic heart disease. It is the most common trigger of a myocardial infarction, or heart attack. The two terms are sometimes used as synonyms.
They are not quite the same, though. Thrombosis is the formation of a clot that narrows or blocks a vessel, while myocardial infarction is the death of heart muscle caused by a lack of oxygen.
The heart muscle gets its blood from the coronary arteries, so the location of the clot matters. In coronary thrombosis, the clot forms in one of these arteries, and the area of heart muscle it supplies is put at risk.
The most common cause of coronary thrombosis is atherosclerosis. "Athero" comes from the Greek for paste or gruel, and "sclerosis" means hardening. In atherosclerosis, fatty deposits called plaque build up inside the artery wall, thickening it and narrowing the channel.
Immune cells such as macrophages and lymphocytes gather around these fatty deposits and cause ongoing inflammation in the artery wall.
Coronary Thrombosis Causes
Coronary artery disease starts with damage to the inner lining of the artery (the endothelium). Once the lining is damaged, fats, cholesterol and inflammatory cells collect at the site and form plaque.
According to the NHLBI, a section of plaque can later rupture. A blood clot then forms on its surface as platelets clump together. If the clot grows large enough, it blocks blood flow and causes a heart attack.
Less commonly, a sudden spasm of a coronary artery can cut off blood flow, even with little plaque. Smoking and cocaine use raise the risk of spasm.
This damage can be caused by various factors and they include
- High cholesterol
- Smoking
- High blood pressure
- Obesity
- Diabetes or insulin resistance
- Sedentary lifestyle
Symptoms Related To Coronary Thrombosis
When too little oxygen reaches the heart muscle, its cells begin to die and the heart can't pump as well. That is why coronary thrombosis often shows up as a heart attack.
Coronary thrombosis is a life-threatening emergency. Symptoms can include:
- Chest pain or discomfort (angina), which may feel like
- Heaviness
- Pressure
- Squeezing
- Fullness or tightness
- Aching or burning
- Shortness of breath
- Pain in the arm, jaw, neck, back or upper belly
- Cold sweat, nausea or lightheadedness
The pain is often felt in the center or left side of the chest and may spread to the left arm, jaw, neck or back. Women, older adults and people with diabetes may have less typical symptoms, such as shortness of breath, nausea or unusual tiredness.
If you think you or someone else is having a heart attack, call 911 right away. Fast treatment can save heart muscle and lives.
How Does Coronary Thrombosis Develop?
Plaque can start building up in the artery walls in childhood or young adulthood and grows as you get older. Plaque is made of cholesterol, fats, calcium, inflammatory cells and other substances.
As more cholesterol and inflammatory cells join in, the plaque grows. It pushes into the artery's channel and narrows it, so blood flow slows.
Narrowing often causes no symptoms for years. Sometimes small new blood vessels grow around a blockage and help supply the heart muscle. During exertion or stress, though, a narrowed artery may not deliver enough blood, which can cause angina.
In many cases, plaque ruptures and a blood clot forms on top of it, suddenly blocking blood flow and causing a heart attack.
A heart attack can also lead to a stroke. For example, a clot can form inside the damaged heart or with an irregular heartbeat and then travel to the brain.
Risk Factors For Coronary Thrombosis
Risk factors for coronary artery disease or coronary thrombosis include
Age
Your risk rises as you get older. In men, risk increases noticeably from about age 45. In women, risk rises more quickly after about age 55.
Sex
Both men and women get coronary heart disease. Obstructive coronary artery disease is more common in men, while women more often have disease of the small heart vessels, which can be harder to diagnose.
Family History
A family history of early heart disease raises your risk. This applies if your father or brother was diagnosed before age 55, or your mother or sister before age 65, according to the NHLBI risk factor guide.
Hypertension / high blood pressure
Uncontrolled high blood pressure damages the artery walls over time and speeds up plaque buildup.
Diabetes mellitus
Type 1 diabetes and type 2 diabetes mellitus both raise the risk of coronary heart disease. High blood glucose damages blood vessels, and diabetes often occurs with other risk factors such as high blood pressure and high cholesterol.
Obesity/ overweight
Excess body weight raises the risk of coronary artery disease and makes other risk factors, such as diabetes and high blood pressure, more likely.
Smoking
Smoking, and long-term exposure to secondhand smoke, damages blood vessels and greatly raises the risk of coronary artery disease.
High Blood Cholesterol
High levels of LDL ("bad") cholesterol increase the risk of plaque buildup and atherosclerosis.
How Coronary Thrombosis Can Be Treated?
A heart-healthy lifestyle helps everyone, whether or not they have coronary artery disease. People who have the disease also need medical treatment from their doctor. Three main approaches are used. They include
1- Lifestyle Changes
Control your blood sugar if you have diabetes, and keep blood pressure and cholesterol in check. Quit smoking and limit alcohol.
Exercise regularly and aim for a healthy weight. Eat more vegetables, fruits, whole grains and lean protein, and cut back on saturated fat, salt and highly processed foods.
2- Medication
Doctors prescribe medicines based on your condition and risk. These may include statins to lower cholesterol, anti-platelet medicines such as aspirin to prevent clots, and medicines for blood pressure and angina.
Don't start daily aspirin on your own. It can cause bleeding and isn't right for everyone, so take it only if your doctor recommends it.
During a heart attack, emergency treatment may include aspirin, nitroglycerin and clot-dissolving medicines (thrombolytics), as described by the NHLBI.
3- Surgery
When an artery is badly narrowed or blocked, procedures can restore blood flow. Common procedures include
- Coronary artery bypass surgery
- Stent placement
- Balloon angioplasty
Angioplasty and stent placement (percutaneous coronary intervention, or PCI) are often done urgently during a heart attack to open the blocked artery.
